梯度回波与自旋回波 echo-planar 成像测量肝脏硬度的磁共振弹性成像技术失败的比较：系统评价和荟萃分析。
Comparison of technical failure of MR elastography for measuring liver stiffness between gradient-recalled echo and spin-echo echo-planar imaging: A systematic review and meta-analysis.
机构信息
The Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
出版信息
J Magn Reson Imaging. 2020 Apr;51(4):1086-1102. doi: 10.1002/jmri.26918. Epub 2019 Aug 27.
BACKGROUND
Magnetic resonance elastography (MRE) using a gradient-recalled echo (GRE) or a recently available spin-echo echo-planar imaging (SE-EPI) sequence is a promising noninvasive method for measuring liver stiffness. However, it sometimes fails to measure stiffness values, thereby resulting in technical failures.
PURPOSE
To assess and compare technical failures of MRE for measuring liver stiffness between GRE and SE-EPI sequences.
STUDY TYPE
Systematic review and meta-analysis.
POPULATION
Eight studies with both GRE and SE-EPI, 22 studies with only GRE, one study with only SE-EPI.
FIELD STRENGTH/SEQUENCE: Either 1.5 or 3T MRE using GRE and/or SE-EPI.
ASSESSMENT
Through an Ovid-MEDLINE and EMBASE database search, original articles investigating the proportion of MRE technical failures in the measurement of liver stiffness published up until October 2018 were screened and selected.
STATISTICAL ANALYSIS
The pooled proportions of technical failures under GRE and SE-EPI were calculated using random-effects meta-analysis of single proportions and inverse variance for calculating weights. Subgroup analyses were performed to explore the covariates affecting heterogeneity. Head-to-head comparisons of technical failure between the sequences were conducted with eight MRE studies using both GRE and SE-EPI.
RESULTS
The pooled proportion of technical failure under GRE MRE was 5.8% (95% confidence interval [CI], 4.6-7.4%), and a subgroup analysis showed higher technical failure rates at 3T than at 1.5T. The pooled proportion of technical failure under SE-EPI MRE was 2.0% (95% CI, 1.3-3.4%), without significant differences (P = 0.38-0.89) being observed in the subgroup analyses. In the eight studies comparing the two sequences, failure was more frequently observed with GRE than with SE-EPI (9.4% vs. 1.9%; P < 0.01).
DATA CONCLUSION
MRE conducted with SE-EPI sequences showed a lower technical failure rate than GRE sequences. With GRE sequences, a magnetic field of 3T was associated with higher technical failure rates than was 1.5T.
LEVEL OF EVIDENCE
1 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1086-1102.
背景
使用梯度回波（GRE）或最近可用的自旋回波回波平面成像（SE-EPI）序列的磁共振弹性成像（MRE）是一种有前途的非侵入性测量肝硬度的方法。然而，它有时无法测量刚度值，从而导致技术失败。
目的
评估和比较 GRE 和 SE-EPI 序列测量肝硬度的 MRE 技术失败率。
研究类型
系统评价和荟萃分析。
人群
8 项研究同时使用 GRE 和 SE-EPI，22 项研究仅使用 GRE，1 项研究仅使用 SE-EPI。
场强/序列：1.5T 或 3T 使用 GRE 和/或 SE-EPI 的 MRE。
评估
通过 Ovid-MEDLINE 和 EMBASE 数据库搜索，筛选并选择了截至 2018 年 10 月发表的关于 MRE 技术在测量肝硬度方面的技术失败比例的原始文章。
统计分析
使用单比例随机效应荟萃分析和逆方差计算权重，计算 GRE 和 SE-EPI 下技术失败的汇总比例。进行亚组分析以探讨影响异质性的协变量。使用 8 项同时使用 GRE 和 SE-EPI 的 MRE 研究进行序列之间技术失败的头对头比较。
结果
GRE MRE 下技术失败的汇总比例为 5.8%（95%置信区间[CI]，4.6-7.4%），亚组分析显示 3T 时技术失败率较高。SE-EPI MRE 下技术失败的汇总比例为 2.0%（95% CI，1.3-3.4%），亚组分析未见显著差异（P = 0.38-0.89）。在比较两种序列的八项研究中，GRE 比 SE-EPI 更频繁地出现故障（9.4%对 1.9%；P<0.01）。
数据结论
使用 SE-EPI 序列进行的 MRE 显示出比 GRE 序列更低的技术失败率。在使用 GRE 序列时，磁场为 3T 时的技术失败率高于 1.5T。
证据水平
1 技术功效阶段：3 J. Magn. Reson. Imaging 2020;51:1086-1102.
Zotero 插件